Enterovirus D68 Information & Prevention



FAQ from the CDC are here.



Posted in 101, Babies!, Children, Health Care, Medicine, Pediatric Bits, Teens, Wellness | Tagged , , , , | Leave a comment

Vaccine Information Statements

Shot TimeVaccine Information Statements provide information on the immunizations given to babies, children, teens and young adults.

Each shot has its own Vaccine Information Statement or VIS.

The VIS explains:

  • why get vaccinated
  • information about the specific vaccine
  • who shouldn’t get vaccinated with this shot
  • risks of vaccine reaction
  • what to do if there is a reaction
  • links for additional information

Parents and patients should review the VIS when shots are given.






Hepatitis B

Hepatitis A







Influenza: nasal

Influenza: injection


Posted in Pediatric Bits, Health Care, Medicine, Babies!, Teens, 101, Children, Wellness | Tagged , , , , , , , , , , , | Leave a comment

Why Doesn’t Cough Medicine Work?

Cover Your CoughThis video explains why cough medicines don’t work. The whole 6 minutes is worth a look, but you can skip to the 2:00 mark on the video to see an animation of mucociliary clearance.

Cilia are the tiny hair-like projections that line the lungs and airways. They beat together in waves to move mucus out of our lungs. When we are healthy, don’t smoke and breath unpolluted air, the cilia work great. The mucus secreted by our airways traps viruses, bacteria, air pollution, allergens and dead cells, sweeping them quietly up to the top of our throat to be swallowed with salvia. Think of it like a tiny escalator.

Infections and irritants damage the cilia. Their beautiful wave-like movement stops. The protective mucus inside the lungs builds up–along with all the extra mucus that colds and pollen and pollution trigger. To clear the mucus, you have to manually clear the lungs. In other words, you have to cough. Watch the video on cough here.

Over the counter cough medicines don’t work because they can’t get the cilia working again. They are sold to suppress cough, and cough suppressants don’t work because they tell the brain, “Hey, don’t cough.” Your lungs, faced with this build up of mucus, are going to cough because cough is a primitive, protective reflex. If you didn’t cough, your lungs would fill up with mucus and there would be no place for the air to exchange oxygen for carbon dioxide.

To suppress cough, you need to heavily sedate the patient, but too much sedative and the patient doesn’t breath. This can happen when people consume too much alcohol or other sedatives.

Doctors suppress cough in a very controlled manner for patients getting general anesthesia or when patients are on a ventilator. The risk to these patients, however, is pneumonia because sedation eliminates the protective cough reflex.

To treat cough, doctors need medicines that repair the waving cilia or we need ways to prevent patients from becoming sick with the infections that do the damage.

For more on cough, see these posts on cough medicines and kids, what’s in cough medicines, and using honey for cough.



Posted in 101, Babies!, Children, DIY, Health Care, Medicine, Pediatric Bits, Teens, Wellness | Tagged , , , , , , , , , , , | Leave a comment

Stop Trying to Sell Vegetables

artichokesEat your vegetables, they’re good for you!

How many times did we hear this as kids, and how many times have we told our own kids?

A recent study published in the Journal of Consumer Research may teach us all an important lesson.

Three groups of children were told three different versions of a story.

One group of children heard that Tara, a girl in the story, had some crackers before she went out to play. A second group of children heard that Tara ate some crackers and that they were yummy and made her feel happy. The third group heard that Tara had some crackers and that they made her feel strong and healthy. The story also reminded the children that crackers were good for them.

Then the researchers put left each child alone in a room with a bowl of crackers.

The children who heard the story about Tara’s healthy crackers ate, on average, only 3 crackers.

The children who were told Tara ate the yummy crackers that made her feel happy ate 7 crackers.

But the children who heard that Tara just ate crackers ate, on average, 9 crackers.

The moral of the story? Kids are smart. The more we try to sell how good a food is, the more suspicious they may get.

Think about it. Have you ever seen an advertisement for raspberries?

I haven’t. I love them. And when I can go pick them or when they are in season and affordable, I buy them. They are yummy. No one has to sell raspberries, they sell themselves.

Try a less is more approach with vegetables. Stop trying to sell them.

Buy them, cook them, put them on the table and eat them.

Stick to age-appropriate portion sizes for starches and proteins and avoid offering “make-up” foods like yogurt and cereal when your child didn’t tuck in at dinner.

And don’t forget this kitchen rule:

Dinner Choices






Posted in 101, Babies!, Children, Medicine, Nutrition, Pediatric Bits, Teens, Wellness | Tagged , , , , , , , , , , , , | Leave a comment

How Can I Make My Child Taller?


Your child’s height is a combination of many things: family genetics and growth patterns, sleep and nutrition.

If there were an easy way to predict your child’s ultimate height, there would be an app for that!

Pediatricians approach this question by taking a history. How tall are mom and dad? Are mom’s and dad’s heights representative for their families?

The mid-parental height is based on mom’s and dad’s heights. You can calculate it for your child here. If, for example, mom is 5’2″ and dad is 6′, then the mid-parental height for a girl is approximately 5’4″ and for a boy it’s 5’9″. The mid-parental height is a calculated height, and the range of expected heights can range from two inches shorter than the mid-parental height to two inches taller than the mid-parental height. So the girl is this example is expected to fall between 5’2″ and 5’6″; the boy is expected to reach 5’7″ to 5’11”.

This four inch spread is considerable, and the range can mean the difference between shorter than average to taller than average. For women, average height is considered to be 5’4″, and for men it’s 5’10”.

Every family has a great-aunt who is 4’10” and a great-grandfather who was 6’5″. Parents almost always hold out hope that the tall genes will prevail.

The pediatrician measures your child and plots their height and weight and reviews the growth chart. I look to see if the child is following a specific line or percentile on the growth chart.

Think of percentile this way: if your child is 50th percentile (50th%), imagine 100 kids lined up. Of these 100 kids, 49 will be shorter than your child and 49 will be taller. 5oth% is the middle, or average. Numbers below this are shorter than average, and numbers above it are taller than average. A child with a height at the 30th% is taller than 30 out of 100 children and considered shorter than average; a child with a height at the 80th% is taller than 80 out of 100 children and taller than average. Remember, the average is over all kids—your child may rank differently in their class or among peers.

The girl in the example above who is at the 50th% for height and continues along that curve should reach 5’4″, which is in the 5’2″ to 5’6″ inch range predicted by her mid-parental height.

The boy in the example above who is at the 75th% and continues along that curve should reach 5’11 1/2″ inches, which is slightly taller than predicted by his mid-parental height. If the boy in the example above is at the 10th% now (which grows up to be 5’6″), he is shorter than expected based on his parents’ heights, but if he has a family history of later puberty, there’s a good chance he may catch up as he gets older.

Children with access to healthy food generally do not fail to grow from malnutrition. To help kids reach their height potential, meals should be balanced with attention to calcium, vitamin D and iron along with all the vitamins, minerals and phytochemicals in fruits, vegetables, whole grains, lean proteins, and healthy fats. A keyword search of this blog with the keyword “nutrition” will provide additional information and resources.

Growth hormone is secreted during sleep, so keep tabs on sleep time. The number of hours of sleep kids need is here.

After the second birthday, children are expected to grow 2 inches each year and to gain about 5 pounds. Growth rates change with puberty. One of the most important reasons for an annual physical is to make sure your child is progressing on the growth chart. Some children may exhibit early signs of puberty. This may affect adult height and should be carefully monitored.

There are many different growth patterns. Some kids follow their height and weight curves year after year. Others may be shorter than average as young children and have later puberties and catch up and sometimes surpass their peers. This is sometimes seen in families with men who got taller after high school and women who menstruated late.

If you have questions about your child’s height, weight or development, talk with your pediatrician.

Whatever your child’s eventual height, this metric is just one physical aspect of your child. Focusing on height alone misses the many wonders of this unique person you are raising.


Posted in 101, Babies!, Children, Health Care, Medicine, Nutrition, Pediatric Bits, Teens | Tagged , , , , , , , , , , ,

From my reading list

back-to-school2These recent op-ed articles about youth sports and career planning are thought-provoking.


Sports Should Be Child’s Play

Is Your Student Prepared for Life

This final piece compiled from back issues of Bananas, describes their RELAX campaign.


Let’s keep the child in childhood.




Posted in Volunteering | Tagged , , , , , , , , , , , | Leave a comment

Blue Ribbon Babies

Blue RibbonA trip to the Iowa State Fair this summer revealed that one of the areas of competition once included a Baby Health Contest. In 1922, 6200 children competed.





Baby Health Contest History

The baby score sheet included questions about mother’s work outside the home, baby’s diet, including age at weaning, formula, age at the introduction of solid foods and cod liver oil. Questions about sleep included what time the child went to bed at night, the number of naps and whether the child slept alone. Marks were given for being chair broken, sleeping with the window open and getting a daily airing.
















While it’s hard to imagine health as a public competition, the urge to compare children is still alive in well in the checkout line. True health and wellness are more than measurements and milestones.






Posted in Babies!, Children, Pediatric Bits, Wellness | Tagged , , , , , , | Leave a comment

Antigua Guatemala: Day 9

IMG_6074Saturday was follow-up clinic. All the children from the ward were discharged, and the ones who had had surgery earlier this week were checked.






IMG_6071It was also time to say goodbye to the group that translated for the Mayan patients and thank the hospital staff and our hosts.





IMG_6083The bus leaves at 3 a.m. for the drive back to Guatemala City and the flight home.




Posted in Volunteering | Tagged | Leave a comment

Antigua Guatemala: Day 8

IMG_6005 IMG_6017 IMG_5940 IMG_6011 IMG_6010

The trays of patient medications are very colorful.





Yesterday, the post-operative care nurse from the hospital came to me to say we were out of the acetaminophen on the left (the red one), and were switching to the one on the right (the blue one).

The red one is 160mg/5 ml.

The blue one is 500mg/15 ml.

Do you know why he and I had a good laugh?




There were plenty of tasty things brought to us in the lunch room.

Lots of coconut, tamarind and flan flavors along with wonderful cakes and cookies made in the hospital’s bakery.






Posted in Volunteering | Tagged | Leave a comment

Antigua Guatemala: Day 7

This little girl and I had quite a lot of fun doing a complete neurological exam after she fell and hit her head yesterday afternoon. Nothing is more fun than the finger-to-nose test.

























It was important to clear her for surgery since she was on the surgical schedule today—our last day in the operating room.









We’ll see her—and all the surgical patients—again tomorrow morning at our closing clinic. We cared for nearly 90 surgical patients over the last five days.



Posted in Volunteering | Tagged | Leave a comment